Factors associated with treatment adherence in a predominantly minority population in a yoga study for chronic low back pain

The Back to Health study is a 12-week comparative effectiveness randomized controlled trial for cLBP. We are recruiting 320 adults with cLBP from community health centers in racially diverse neighborhoods of Boston, MA. They are randomized in a 2:2:1 ratio to yoga, physical therapy, and education treatment arms. During the 12-week intervention period, yoga participants engage in a standardized once per week hatha yoga protocol delivered in a class format and supplemented by home practice. Activities to enhance adherence include flexible yoga class schedules, small class sizes (<10), weekly reminder phone calls, assistance with child care or transportation, make-up classes, attendance based raffles, staggered distribution of honoraria, and yoga take home practice supplies. Pain-related disability is measured using the Modified Roland Morris Disability Questionnaire (RMDQ) (0-23 scale). Treatment adherence is measured by class attendance and was defined as at least 75% class attedance. We will compare mean RMDQ scores for those adherent and non-adherent using a T-test. We will determine if the RMDQ score is independently associated with adherence using a logistic regression, controlling for possible confounders. For the first cohort (n=34), the overall attendance rate was 76% and 25 participants (74%) were compliant, attending at least 9 classes in the 12-week study period. Analysis of further cohorts is ongoing. An analysis will be conducted to determine if self-reported disability predicts treatment adherence. Results will determine the effects of cLBP-related disability on treatment adherence. Overall, results will highlight the feasibility of attaining treatment adherence for cLBP sufferers participating in a yoga research trial.